Central neck dissection in the management of sporadic medullary thyroid microcarcinoma

Hamy, A.; Pessaux, Patrick; Mirallié, Éric; Mucci-Hennekinne, S.; Gibelin, Hélène; Mor-Martinez, C.; Calan, L. De; Ronceray, J; Kraimps, Jean‐Louis

doi:10.1016/j.ejso.2005.03.007

Cited by 42 publications

(37 citation statements)

References 16 publications

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“…This threshold agrees with a recent report suggesting more aggressive behaviour in tumours measuring O0.5 cm in size (13) and cure rates of 80% (13). In other studies, cure rates of 71-100% were reported (11,19,22,24). The variance in cure rates may be due to differences in the chronological periods and the ratio of familial disease.…”

Section: Discussionsupporting

confidence: 81%

“…In microMTC patients with positive lymph nodes at diagnosis, undetectable post-operative calcitonin was found in 28.6% compared with 76.8% in those without positive lymph nodes at diagnosis, roughly agreeing with the findings of Scollo et al (15) (32 vs 95%). However, there are controversies in the literature concerning the need for systemic lymph node dissection in lesions %0.5 cm in size (4,7,11,12,13). It is possible that the definition of lymph node dissection may have varied in these studies (25).…”

Section: Discussionmentioning

confidence: 99%

“…The genetic background and specific molecular events might be responsible for such differences (26). Nevertheless, early diagnosis and the appropriate surgical management can improve the outcome (4,7,11,12,13,16,27). It should be recognised that the majority of small-sized MTCs appear to be innocent not affecting the overall survival (6,16,28).…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have shown no aggressive behaviour. Hamy et al only observed lymph node involvement; thus, older studies have questioned the extent of surgical treatment needed (7,11,12). However, two recent studies have reported that even small tumours may present with more advanced disease (4,13).…”

Section: Introductionmentioning

confidence: 99%

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Small medullary thyroid carcinoma: post-operative calcitonin rather than tumour size predicts disease persistence and progression

Saltiki

Rentziou

Stamatelopoulos

et al. 2014

European Journal of Endocrinology

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Objective: Recently, small medullary thyroid carcinomas (smallMTCs; %1.5 cm) are frequently diagnosed, occasionally as incidental findings in surgical specimens. Their clinical course varies. We examined tumour size as a predictor of clinical behaviour. Design: A retrospective study. Methods: A total of 128 smallMTC patients (35.2% males and 45% familial) were followed up for 0.9-30.9 years. According to tumour size (cm), patients were classified into four groups: group 1, 0.1-0.5 (nZ33); group 2, 0.6-0.8 (nZ33); group 3, 0.8-1.0 (nZ29) and group 4, 1.1-1.5 (nZ33). Results: Pre-and post-operative calcitonin levels were positively associated with the tumour size (P!0.001). Capsular and lymph node invasion were more frequent in groups 3 and 4 (P!0.03); the stage was more advanced and the outcome was less favourable with an increasing tumour size (P!0.001). Groups 1 and 2 patients were more frequently cured (group 1, 87.8%; group 2, 72.7%; group 3, 68.9%; and group 4, 48.5%; PZ0.002). The 10-year probability of lack of disease progression according to the tumour size differed between patients with tumour sizes of 0.1-1.0 and 1.1-1.5 cm (96.6%, 81.3%, x 2 Z4.03, PZ0.045 for log-rank test). Post-operative calcitonin was the only predictor significantly associated with the 10-year progression of disease. Post-operative calcitonin levels R4.65 pg/ml predicted disease persistence (sensitivity 93.8% and specificity 90%) and R14.5 pg/ml predicted disease progression (sensitivity 100%, specificity 82%, receiver operating characteristic curve analysis). Conclusions: Tumour size may be of clinical importance only in patients with MTCs O1 cm in size. Post-operative calcitonin is a more important predictor than size for disease progression.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Small medullary thyroid carcinoma: post-operative calcitonin rather than tumour size predicts disease persistence and progression

Saltiki

Rentziou

Stamatelopoulos

et al. 2014

European Journal of Endocrinology

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“…However, serum calcitonin may also be increased owing to other conditions such as renal failure, neuroendocrine tumors, hypergastrinemia, hypercalcemia, pseudohypoparathyroidism, and even increased age [10,[17][18][19]. Additionally, it is worth noting that serum calcitonin levels may not be elevated in patients with small-sized MTCs [9,20].…”

Section: Discussionmentioning

confidence: 99%

Fine-needle aspiration cytology for medullary thyroid carcinoma: a single institutional experience in Japan

et al. 2017

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Medullary thyroid microcarcinoma

Kazaure

Roman

Sosa

2011

Cancer

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BACKGROUND: Medullary thyroid microcarcinomas (microMTCs) are medullary thyroid carcinomas (MTCs) that measure 1 cm in size for which there is a paucity of data on incidence, characteristics, and clinical significance. METHODS: Patients who had a diagnosis of microMTC were abstracted from the Surveillance, Epidemiology, and End Results database (1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007). The data were analyzed using chi-square tests, t tests, and log-rank tests; multivariate logistic regression was used to identify factors that were associated independently with lymph node metastases. Tests for diagnostic accuracy, including likelihood ratio tests and post-test probability tests, were computed to evaluate the size-specific likelihood of developing lymph node metastases among patients with microMTC. RESULTS: In total, 310 patients had microMTC; its incidence increased during the study period (P trend ¼ .033), and microMTC as a proportion of all MTCs increased by 39%. The mean tumor size was 5.7 mm. Thirty-one percent of tumors were multifocal, and 7.8% had extrathyroid extension. Lymph node metastases occurred in nearly 37% of patients who had any lymph nodes removed (65 of 176 patients). Nearly 20% of patients had regional disease, and 5% had distant metastases. The overall 10-year survival rates for patients with localized, regional, and distant disease stages were 96%, 87%, and 50%, respectively (P < .001). After adjustment, extrathyroid extension (odds ratio [OR], 41.9; P < .001) and tumor size (OR, 1.2; P ¼ .008) retained an independent association with lymph node metastases. MTCs that measured 5 mm were associated with a probability of lymph node metastases of approximately 23%, and the probability increased for patients who had tumors >5 mm. CONCLUSIONS: The current results indicated that microMTCs have significant rates of poor prognostic features known to impact the survival of patients with MTC. These microcarcinomas are an important clinical entity that requires comprehensive evaluation and surgical management. Cancer 2012;118:620-

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Central neck dissection in the management of sporadic medullary thyroid microcarcinoma

Cited by 42 publications

References 16 publications

Small medullary thyroid carcinoma: post-operative calcitonin rather than tumour size predicts disease persistence and progression

Small medullary thyroid carcinoma: post-operative calcitonin rather than tumour size predicts disease persistence and progression

Fine-needle aspiration cytology for medullary thyroid carcinoma: a single institutional experience in Japan

Medullary thyroid microcarcinoma

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